HMO lawsuit bill mirrors legislation Thrasher backed

He pushed in 1996 for a bill allowing customers to sue HMOs. A similar bill is in the works, and Thrasher is against it.

TALLAHASSEE -- Four years ago, Republican Rep. John Thrasher wrote a letter asking then-Gov. Lawton Chiles to support a bill allowing patients to sue HMOs for damages.

Chiles, a Democrat, vetoed the bill.

This year, Thrasher adamantly opposes measures that would allow patients to sue health maintenance organizations when care is improperly denied. As House speaker, he has refused to take up several right-to-sue bills now moving through the Republican-controlled Senate.

But in a move designed to put pressure on Thrasher, the Senate Banking and Insurance Committee passed a bill Monday that Senate Majority Leader Jack Latvala said is virtually identical to the compromise Thrasher helped broker in 1996.

"It's hard to justify not supporting a bill the language of which you helped broker among interested parties," said Neal Roth, president of the Academy of Florida Trial Lawyers. "And, yeah, Speaker Thrasher, I want to hear an explanation as to what has changed between then and now."

Thrasher's spokeswoman Katie Baur said much has changed.

"One, that was four years ago," Baur said. "Republicans were not in the majority. The speaker was not the speaker -- he was asked by his leadership to work out a compromise. Sometimes, you are forced to compromise to make bills better, but if you were in charge, it would not be legislation that would even be on the table."

Since that time, Baur said: "we've seen the aftermath of the economic jihad the trial lawyers have waged against small business or anyone they believe has deep pockets. All of us learn from experience. And what we have learned is that lawsuits only drive up health care costs while doing little to nothing to improve care."

The Florida bill that passed the Senate committee Monday, sponsored by Latvala, does not go as far as some proposals. It gives patients only a limited right to sue HMOs. It contains the 1996 compromises Thrasher, in a letter written four years ago, said "strikes a fair balance between the HMO industry and its health care consumers." The letter was co-signed by Rep. John Cosgrove, a Miami Democrat who this year is running for insurance commissioner.

Under Latvala's proposal, a patient only may sue if an HMO fails to provide a covered service that a doctor under contract with the HMO has independently deemed medically necessary. A patient may not sue if the HMO refuses to provide the service on the grounds that the cost is unreasonably high.

In addition, patients must give HMOs a 60-day written notice of their intent to sue. A patient may not sue if, within those 60 days, the HMO chooses to provide the service or the circumstance that gave rise to a patient's complaint is corrected.

Latvala said the proposal represents a "good balance."

"I'm not a guy who goes out looking for reasons to file lawsuits," Latvala said. "But I think we need to have a hammer over the heads of these HMOs to get them to do the right thing by their customers."

Latvala's effort is supported by the Florida Medical Association. But it is opposed by a host of business groups and the HMO industry, who argue that it will drive up premium costs and increase the rolls of the uninsured. Industry representatives pointed to Chiles' 1996 veto message, in which he credited the managed-care industry with helping bring health care costs under control.